Organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Active
Organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Active
Other names
Child Development Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BROOKE W ROSSHEIM M.D., M.P.H. (DIRECTOR)
(540) 899-4797
Entity
Organization
Contact information
Practice address
10708 BALLANTRAYE DRIVE, SUITE 204, FREDERICKSBURG, VA 22407-4701
(540) 891-3151
(540) 891-3152
Mailing address
608 JACKSON STREET, FREDERICKSBURG, VA 22401-5719
(540) 899-4797
(540) 899-4599
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
VA
251K00000X
Public Health or Welfare Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007600399
VIRGINIA PREMIER
VA
05
—
007600399
—
VA
01
—
27523
OPTIMA/SENTARA
VA
Enumeration date
07/05/2006
Last updated
06/13/2011
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